Device to ease childbirth



Jan. 16, 1940. M. HORNSTEIN 2,137,125

DEVICE T0 EASE CHILDBIRTH Filed Feb. 2, 1937 fl/M/r flaw 5mm I INVENTOR 4/5 ATTORNEY Patented Jan. 16, 1940 f UNITED STATES Mark Hornstein, New York, N. Y.

Application February 2, 1937, Serial No. 123,587

4 Claims.

This invention relates to methods and devices for easing childbirth.

Childbirth seldom meets with serious difiiculties where the opening of the womb has 5 proceeded to the ideal culmination. The ideal, however, is not attained merely by a degree of dilatation which may be said arbitrarily to allow passage of the head. The ideal degree of opening is more than a spreading of the orifice of the organ. Authorities recognize that it consists of a pulling up of the lower passive portion of the womb into the upper active uterine musculature as a result of the muscular action of the latter. The resultant spreading of the orifice is v a necessary incident resulting from pull exerted upon every point of the orificial ring. So that it may be truly said that the womb opening is pulled up past the head rather than the head passing through the opening. v 2 0 Three indispensable consequences of the above are: I

l. The child can emerge from the Womb. 2. The tight bony pelvis is cleared of womb and is entirely available for descent and passage of 'the head.

3. The shortened womb is thicker and stronger for the ensuing expulsion of the child from the pelvis.

The numerous instances of difficulty in child- ,30 birth are usually associated with imperfection in this evolution of the lower portion of the womb and the obstetrician is frequentlycompelled after days of waiting to resort to the use of instruments before the completion of this so-called first stage of labor. Not only is the child pulled through an insufliciently open womb with resultant tearing of the neck of this organ, but the pulling is also done through a tight bony pelvis into which the muscular tube constituting the lower end of the Womb is telescoped. The head is therefore being forced through a virtually smaller pelvis. Not uncommonly, this causes excessive compression of the soft head, injuries to the brain, and death of the child. Before the long, tedious labor has finally been endedthe woman has undergone days of sufiering and exhaustion and may become easy prey to infection to which the long labor has exposed her.

In search for the cause of this arr-est or delay in the evolution during labor of the lower portion of the Womb, irrespective of any other concomitant aberration from the accepted normal, it has seemed to the author that the chief hindrance rests in the pressure of the head against the sides of the lower portion of the Womb. That labor.

(Cl. 128-361) the head acts as a drag upon this portion, de-

laying its upward excursion and causing, moreover, the uterine contractions to be more painful than necessary. The fact that early breaking of the water bag often goes hand in hand with ;;5 delayed labor is only one corroborative factor. The usual positions assumed by the expectant mother during labor seemed to be the main cause.

Experimenting with the woman in the knee- 10 elbow and in the knee shoulder position did bring about startling results in promoting progress in' These positions, however, are not easy to maintain for a sufficient time as they cause some degree of exhaustion and are dependent 1-5 upon the Willingness of the patient to cooperate. As the patient must be kept wide-awake it is not feasible to administer drugs for therelief of pain and although in the normal case the benefits of the posture are so rapid that exhaus .20 tion does not take place and even relief from drugs can be dispensed with, in the more difficult case a longer maintenance of the posture is not practicable, much as this is necessary.

The appliance has therefore been devisedto..25 overcome these shortcomings. By the use of this, the patient is kept comfortable and relaxed. Drugs may be given and the posture may be maintained for many hours without due objections by the patient. 30

The posture recommended is that which will favor upward recession of the Womb and its contents. these are brought out of the true narrow pelvic cavity the lower portion of the womb is no longer hindered in its upward'excursion by 35 pressure of the head against it and in turn against the walls of the. true pelvis. The contractions of the womb immediately become orderly, rhythmic and strong, at the same time distinctly less painful. The openin'gand upward excursion of 40 the lower portion proceeds apace'and the results are frequently astonishing, nearly always substantial.

While the results achieved by the method are self-evident the explanations for their occurrence 45 .are at variance with established teaching. The] general view is that the head must be engaged in the true pelvis even before the onset of labor. This assumes the requisite existence of a pelvis which is large enough to accommodate not only .50 head but head clothed with a thick muscular coat, the lower uterine portion. Closer observation shows that where these conditions are met natural processes bring about upward displace ment of the head as soon as labor starts provided .55

that there is a sufiicient amount of amniotic fluid forced down below the head by the pressure exerted from above by the contractions of the uterine musculature, thus floating the head back and prompting a progressive labor. Where this condition is not met, either on account of scanty fluid, early breaking of the water bag, or other mechanical conditions labor is retarded.

Summing up the main advantages of the new method and the device through which it operates, they are: Shortening of the normal and retarded labor, shortening the time required to prepare the abnormal case for corrective treatment, diminution in the incidence of intracranial injuries to the child, practical elimination of lacerations of the neck of the womb and thesequelae of this injury, less cause for operating and instrumental delivery.

Aside of a novel posture and method of easing childbirth, my invention also relates to a device for aiding the expectant mother to keep in this desirable position in a pleasing, non-tiring and efficient manner.

In the drawing forming a part of this specification and accompanying the same:

Fig. 1 is a perspective View of my device to be used for aiding and easing childbirth;

Fig. 2 is a side elevation thereof, portions of the same having been broken away;

Fig. 3 is a front elevation, portions of the device having been removed;

Fig. 4 is a fragmentary detail showing the shape and arrangement of a central opening in my invention, and a Fig. 5 is another fragmentary sectional detail showing the method for removably securing a textile body on the frames of my devices, while Fig. 6 is a diagram showing the application of my device and said favorable position of an expectant mother.

Referring now to the diagram of Fig. 6 show- .ing the basic idea of my invention and the application of one form of my device, the expectant mother is generally indicated by the numeral Ii] and she is kept in a downwardly turned position,

the head possibly resting on the pillows H.

My device is generally indicated by the numeral l4 and is in the form of a transverse arch placed underneath the center of the body and may be used for the main support thereof permitting the rest of the body to change its position, to move about for momentary rest and relaxation if the expectant mother so desires, the device E4 being placed on the bed l2, l3, as shown.

An opening l5 may be provided in the arch l4 and the center part 86 of the underside of the body of the expectant mother may freely depend therefrom, thereby aiding, or making possible, the favorable conditions as to the pelvic opening, the womb, and the head of the fetus, explained 'hereinbefore.

Referring now more closely to the embodiment of my device to be used in connection with this novel method of aiding childbirth, said device, ashas been mentioned hereinbefore, is generally an arch shaped body M, in the embodiment shown having two arcuate longitudinal or side frames I1 and I8 kept at a desired distance by two transverse pipe members i9 and 20 arranged between the respective lower ends of the two arcs ll and I8. .A tie rod 2! may pass through each transverse pipe l9 and 20 having a head 22 at one end and a wing nut 23 at the other whereby 'the ends of the arcs ll and 18 may be tightly clamped on said transverse pipes l9 and 20, as will be understood.

A textile sheet material 24, preferably a canvas sheet is stretched out between the frame members ll, l8, l9 and 20 forming an are proper 25 of slightly and resiliently yielding character. The marginal edge portions of said canvas are formed with tubular loops 26 encircling the arcuate and transverse frame members l'l, l8, l9 and 20.

My device when assembled will cause the canvas member 24 to be comparatively tightly stretched between the said frame members forming the arch shaped body shown in Fig. 1.

In the top center portion of my device I also arrange an opening 21, preferably of oval shape, the longer axis of the oval being in parallelism with the planes of the arcs IT and I8 and said opening preferably also showing incisions 28 at its four centers for the purpose described hereinbefore, which incisions, however, may be omitted.

It will be understood that the edges of the opening 21 may be lined or otherwise made more comfortable to bear, and that the rear end of my device, in the diagrams generally indicated by the numeral 29, will be somewhat raised, as for instance making the rearward end of the arcs H and [3 indicated by the numeral 30 somewhat wing nuts 23 will first be removed, then the tie rods 2! will be pulled out of the transverse pipe members l9 and 28, whereupon the canvas body 24 may be pulled off the arc frames ll and E8 together with the pipe members is and 2E, and the device again set up with the same case in a reverse manner, when it is desired to use it.

As has been pointed out, it is desirable to place the parturient woman in the knee-elbow position.

But as this position may have the effect of producing fatigue and offers other obstacles, I invented this appliance which overcomes such objections. This appliance aims to produce the same effects as the knee-elbow position, to wit:

to keep the trunk of the body in a generally horizontal position and to allow the abdomen and its contents to remain suspended vertically from the trunk. While so suspended, the womb and its contents, principally the child, owing to their own weight are lifted out of the pelvic cavity, 1

thus allowing the lower pole of the womb including the opening free play, and thus promoting, easing and accelerating the opening of the womb.

The manner in which the appliance accomplishes these objects consists of applying support chiefly in two areas: The bony pelvic girdle, at the lower end, and the bony region of the breastbone and adjoining ribs, at the other. Some support is also applied to the soft flanks by means of the sides of the central opening. The abdomen remains freely suspended through the opening. It is also essential that the suspended abdomen remain freely exposed and accessible to the physicians hands for purposes of palpation as this is his chief means of ascertaining the degree of progress of the labor.

While the knee-elbow position and the arch- .shaped support, described hereinbefore, are preferred in my novel treatment and device to ease childbirth, beneficial results may also be atsaid arch shaped body having two longitudinal.

tained if the expectant mother is simply kept in a resting position face downward, a support being provided for the parts of the body around the abdomen, as has been pointed out hereinbefore, While the abdomen is permitted to freely depend through an opening into a space within said support, a further opening or openings at the side or at the bottom of the device being provided to give easy, direct and unobstructed access to the abdomen for the described operations, observations and manipulations of the attending physician.

While I have described a preferred embodiment of the device, it is to be understood that changes and variations may be made in the details of construction thereof, and I desire to reserve my rights to all such changes and variations which are within the spirit of this specification and the scope of the claims hereunto appended.

What I claim as new, is:

1. A support for the underside of the middle portion of the body of an expectant mother, before childbirth, comprising an arch shaped body adapted to be placed transversely underneath said portion of the body of the expectant mother, an opening being provided in said arch permitting the abdomen to freely depend therethrough, said arch shaped body having two longitudinal arcuate end frame portions, and a sheet material secured on said frames and stretched between them.

2. A support for the underside of the middle portion of the body of an expectant mother, be-

fore childbirth, comprising an arch shaped body adapted to be placed transversely underneath said portion of the body of the expectant mother, an opening being provided in said arch permitting the abdomen to freely depend vtherethrough,

arcuate end frame portions, a sheet material secured on said frames and stretched between them,

body adapted to be placed transversely underneath said portion of the body of the expectant mother, an opening being provided in said arch permitting the abdomen to freely depend therethrough, said arch shaped body having two 1ongitu'dinal arcuate end frame portions, a sheet material secured on said frames and stretched between them, two transverse members extending between the respective ends of said arc frames, and means to detachably secure the respective ends of the arcuate and longitudinal frame members to one another.

4. A support for the underside of the middle portion of the body of an expectant mother, before childbirth, comprising an arch shaped body adapted t obe placed transversely underneath said portion of the body of the expectant mother, an opening being provided in said arch permitting the abdomen to freely depend therethrough, said arch shaped body having two longitudinal arcuate end frame portions, a sheet material secured on'said frames and stretched between them, two transverse members extending between the respective ends of said are frames, means to detachably secure the respective ends of the arcuate and longitudinal frame members to one another, and means to remove said sheet and said transverse members from said are members, or replace them thereon.

' MARK HORNSTEIN. 

